| Contact Information | |
|---|---|
| First Name | Domenica |
| Last Name | Susser |
| Address | 3 McCormick Lane |
| City | Blakeslee |
| State | PA |
| Province | |
| Zip/Postal Code | 18610 |
| Country | United States |
| Home Phone | 570 - 646-7447 |
| Work Phone | 570 - 646-7447 |
| Fax | |
| mimi61967@yahoo.com | |
| Alternate Email | mimi61967@yahoo.com |
| Website Address | |
| Gender | Female |
| Injury Information | |
| The injured person is | Child |
| Name of Injured | Jonathan - Susser |
| Date of Injury | 3.22.98 |
| Type of Injury | Obstetric |